Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $535.66 / $634.33 / $1,174.18	Facility		$535.66	$634.33	$1,174.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $535.66 / $643.04 / $918.98	Professional		$535.66	$643.04	$918.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,457.63 / $1,486.78 / $2,915.26	Facility		$1,457.63	$1,486.78	$2,915.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,092.50 / $1,092.50 / $2,508.98	Professional		$1,092.50	$1,092.50	$2,508.98
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,129.41 / $1,214.42 / $1,214.42	Facility		$1,129.41	$1,214.42	$1,214.42
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,214.42 / $1,214.42 / $1,214.42	Professional		$1,214.42	$1,214.42	$1,214.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $843.35 / $843.35 / $843.35	Facility		$843.35	$843.35	$843.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $716.85 / $716.85 / $843.35	Professional		$716.85	$716.85	$843.35
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $1,457.63 / $3,279.67	Facility		$319.00	$1,457.63	$3,279.67
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $860.00 / $1,093.22 / $2,655.80	Professional		$860.00	$1,093.22	$2,655.80
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,106.38 / $1,106.38 / $1,106.38	Facility		$1,106.38	$1,106.38	$1,106.38
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $876.34 / $931.12 / $1,214.42	Professional		$876.34	$931.12	$1,214.42
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $843.35 / $1,457.63	Facility		$597.00	$843.35	$1,457.63
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $716.85 / $843.35 / $2,171.87	Professional		$716.85	$843.35	$2,171.87
United Facility/Professional Facility Modifier Low / Median / High Price $1,799.54 / $1,799.54 / $1,799.54	Facility		$1,799.54	$1,799.54	$1,799.54
United Facility/Professional Professional Modifier Low / Median / High Price $484.80 / $897.78 / $1,336.35	Professional		$484.80	$897.78	$1,336.35
Univera Facility/Professional Facility Modifier Low / Median / High Price $876.34 / $876.34 / $876.34	Facility		$876.34	$876.34	$876.34
Univera Facility/Professional Professional Modifier Low / Median / High Price $876.34 / $876.34 / $931.12	Professional		$876.34	$876.34	$931.12